Delirium in Elderly Patients:Frequency and Precipitants in a Tertiary Hospital Setting

West Afr J Med. 2019 May-Aug;36(2):183-188.

Abstract

Objective: There is paucity of information on delirium in sub-Saharan Africa (SSA) particularly in the older persons (>60 years of age), leaving questions about the burden of the disease in an environment with lower health care standards. In this article, we set out to determine the frequency, precipitants and symptomatology of delirium in elderly patients admitted into medical wards in a teaching hospital in South-West Nigeria.

Methods: This was a descriptive study involving a pre-planned sample of one hundred and fifty patients aged 60 years and over, assessed for cognitive impairment and delirium using the previously validated IDEA cognitive screen, and the Confusion Assessment Method (CAM) respectively. Diagnosis of delirium was made using the CAM and DSM-IV criteria.

Results: Delirium was diagnosed in 32 patients giving a frequency of 21.3% (95%CI: 14.7-30.0%). Patients with delirium were significantly older (p<0.05). A quarter of the patients had dementia. Hypertension was a notable co-morbid condition. All the patients had altered sleep wake cycle, inattention, disorientation, and altered consciousness. Neurological diseases were the most common precipitant. There was a good agreement between the DSM-IV and CAM diagnoses.

Conclusion: Delirium is common in hospitalised elderly patients particularly those with neurological diseases. Co-morbidities like hypertension, dementia, and depression should be looked for in delirious elderly patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / epidemiology
  • Comorbidity
  • Confusion / diagnosis*
  • Confusion / psychology
  • Delirium / diagnosis*
  • Delirium / epidemiology
  • Delirium / psychology
  • Dementia / diagnosis*
  • Dementia / epidemiology
  • Diagnostic and Statistical Manual of Mental Disorders
  • Humans
  • Hypertension / epidemiology
  • Mental Status Schedule / statistics & numerical data
  • Middle Aged
  • Nervous System Diseases / epidemiology
  • Neuropsychological Tests / statistics & numerical data
  • Nigeria / epidemiology
  • Sleep Wake Disorders / epidemiology
  • Tertiary Care Centers